Managing Agitation and Aggression

Understanding Triggers

Agitation and aggression are often triggered by an underlying cause. Usually, there is a specific reason for the behavior, and discovering the trigger will help you identify what you can do to best support your loved one in the moment and how to avoid certain triggers, when possible, in the future.

Possible Triggers

• Physical Discomfort: pain, depression or stress
• Fatigue: too little rest or sleep
• Constipation
• Personal Hygiene Issues: soiled underwear or diaper
• Environmental Changes: sudden changes in familiar places, routines, or people
• Feelings of Loss: loss of independence (i.e. missing the freedom to drive
• Overstimulation: too much noise, confusion, or too many people in the room
• Pressure: being pushed to do something difficult or impossible, like bathing or remembering events or people
• Loneliness: lack of social interaction
• Medication Interactions

Deescalating the Challenging Behaviors

When someone with dementia experiences heightened emotions, this can create stress for themselves as well as their caregiver. It’s important to be prepared to face these moments with strategies to deescalate or reduce the intensity of the situation.

Strategies for in the Moment

• Keep your voice calm.
  Avoid arguing or raising your voice, which may escalate the situation. By keeping calm yourself, you will help your loved one calm down too.
• Reassure your loved one.
  Listen to their concerns and show understanding of the anger or fear they may be feeling.
• Distract with favorites.
  Have a go-to list of familiar items – snacks, photos, songs, conversation topics, favorite object – that your loved one enjoys. When your loved one is stressed, use one or more of their favorite things to help distract their mind and deescalate the situation.
• Use calming techniques.
  Gentle touch, soothing music, reading or a relaxing walk with fresh air may have a calming impact.
• Create a calm environment.
  Be sure to minimize noise, clutter and the number of people in the room.

Strategies to Reduce the Frequency of Agitation and Aggression

• Encourage independence.
  Allow your loved one to do as much as they are able to do on their own and offer support to them only when needed.
• Maintain a routine.
  Establish a consistent and predictable daily schedule.  Predictability can reduce your loved one’s confusion, anxiety and stress level.
• Balance your day.
  Quiet times throughout the day can be just as important as activities. Finding a good balance of stimulation and rest will be beneficial for your loved one.
• Limit caffeine.
  Caffeine may intensify your loved one’s agitation. Reducing their daily intake can be beneficial.

Learning more about agitation and aggression in those with dementia can help you as a caregiver. When you have an informed perspective, you can approach your care with compassion and understanding.

Always remember that your safety and the safety of your loved one is essential. If you are struggling with managing your loved one’s behaviors, talk to your medical provider for ideas and support.